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HomeMy WebLinkAboutMiscellaneous - 1401 GREAT POND ROAD 4/30/2018 (13) ._..- �. •--- - -----� f. Date.• -7 3^� ... . ,AOR TI, 3r 01 p TOWN OF NORTH ANDOVER • . PERMIT FOR GAS INSTALLATION 5 �9SSACMUSESS J1 This certifies that r_:r .�•!:�''.•: . .: . . . . . . . . .. . . . . . . . . . . . . . has permission for gas installation, . -.� - !. . . . . . . . . . . in the buildings of . .:'^` ' . . . . j at . . . . . . . !. . . . . . . . . . . ? . . . . . . . ., North Andover, Mass. Fee ' . f. Lic. No�:/?/il GAS INSPECTOP 0 � Check# 4 90 MASSACHUSETTS UNIFORM UCATONFOR PERNW TO DO GAS FTrnNG (Type or print) Date J,1— NORTH ANDOVER,MASSAC US TTS .j Building Locations �� Y1 / Permit# Al 9� Amount$ Owner's Name New® Renovation Replacement Plans Submitted a ^ ;Y" � dG O C7 W O U F x o Jl/ 02rn p O O O z F L � w C [fit E. ` O a 9 5► � a z cCW7 EW+ z WWF z F O O SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . F L O O R 4TH . FLOOR 5TH . FLOOR 6TH . F L O O R 7TH . FLOOR r 8TH . FLOOR (Print or type) l I,, , Chec one: Certificate Installing Company Name Lc UJ/'r d C.-e . /, /�V(,r c7 Corp. V L1 Address Partner. usmess Te ep ne X Firm/Co. Name of Licensed Plumber or Gas Fitter �� , v .,.ti, t. -P E-e-G INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0 No E] f If you have checked Les,please indicate the type coverage by checking the appropriate box. Liability insurance policy 1 Other type of indemnity D Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent i hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse State Gas Code and C pter 142 of the General Laws. By: Signature of Licensed ber Or Gas Fi er Title Plumber ;?"01// / City/Town Gas Fitter 73cense Number Master APPROVED(OFFICE USE ONLY) Journeyman Location 1/0/ �, f �' `f TV No. 3-5-0 Date 2 Y-2 - U d HORTN TOWN OF NORTH ANDOVER Certificate of Occupancy $ �1S'^••°�Eta' Building/Frame Permit Fee $ 39' s�cNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ -3 Check # G-3 1 3 . 7 r} Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING �ryq BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/12§0dor of Buildings Date Z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: ,# Map Number Parcel Number �J `l Cr) 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record Name rint) Address for Service: Signa re Telephone O 2.2 Owner of Record: Name Print Address for Service: Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Crnnsttvction Su sor: Not Applicable ❑ � os Licensed Con�'cuction Supervisor: \41 'N ��SSC' ,��' �k , Z License Number 0 Address _ � `� C� ( ? Expiration Dat Sig ature Telephone 3.2 Registered ome Improvement Contractor Not Applicable ❑ v Company l amen—y Registration Number A ss r Sign'a'ture Telephone Expiration Date Y^♦ SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildkg permit. Signed affidavit Attached Yes.......Rr No.......0 SECTION 5 Description of Proposed Work check all a Ucable New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) Addition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Pe fY Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIATE USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee �ccc CIL Multiplier 2 Electrical (b) Estimated Total Cost of C,LCC Construction 3 Plumbing Building Permit fee(8)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT.OR CONTRACTOR APPLIES FOR BUH DING PERMIT k ,as Owner/Authorized Agent of subject property Hereby authorize � �( 1�'7� Ut to act on My behal; 'n al natters relative to work authorized-by this building permit application. -77w) L L Signature of O ler Date SECTION 7b O gWNER/AUTHORIZED GENT DECLARATION ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE die (cu�anrairtneallri a�, flruuc�r%ells BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR M Number: CS 028538 Birthdate: 09/05/1948 Expires:09/05/2001 Tr,no: 4729 Restricted To: 00 MICHAEL V RODDEN _ 47 PRESCOTT ST ! , N ANDOVER, MA 01845 Administrator 1 k.. \_~ HOME 1"PROUENE4I CONTRACIOR - — Ragisfration: 105903 Expiration: IYPe: Individual MICHAEL 1. ROODEN Michael Podden ADMI ns;R;Toa 17 Prescott Street No, Andover 1a Oi8l5 A ORD„ CERTIFICATE OF LIABILITY INSURANCE 07/12/2a 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NORTH ANDOVER INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9 WAVERLY ROAD HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR NORTH ANDOVER, MA 01845-241 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P:978-686-2266 F:978-686-6410 INSURERS AFFORDING COVERAGE INSURED INSURER A: TRAVELERS PROPERTY CASUALTY Michael V. Rodden 47 Prescott street INSURER B: INSURER C: North Andover MA 01845— INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ ❑ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ ❑ CLAIMS MADE F1_-3 OCCUR MED EXP(Any one person) $ ❑ PERSONAL&ADV INJURY $ ❑ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ ❑ POLICY ❑ PROJEC- ❑ LOC AUTOMOBILE LIABILITY ❑ COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ❑ ALL OWNED AUTOS ❑ BODILY INJURY $ SCHEDULED AUTOS (Per person) ❑ HIRED AUTOS ❑ NON-OWNED AUTOS BODILY INJURY(Per (Per accident) PROPERTY DAMAGE ❑ (Per accident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ FEEI ANY AUTO OTHERTHAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ ❑ OCCUR a CLAIMS MADE AGGREGATE $ ❑ 8 DEDUCTIBLE $ ❑ RETENTION $ WORKERS COMPENSATION AND ® WC STATU- 10 1 OTH- EMPLOYERS'LIABILITY A 820UB849K419500 01/01/2000 01/01/2001 E.L.EACH ACCIDENT $ 100,000 E.L.DISEASE-EA EMPLOYE $ 100,000 OTHER E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER 101 ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWN OF NORTH ANDOVER DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 010 DAYS WRITTEN NORTH ANDOVER TOWN HALL NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR NORTH ANDOVER MA 01845— REPRESENTATIVE AUTH FNSENTATiVE� ACORD 25S(7/97) ©ACORD CORPORATION 1988 NORTH e O ® 4 Andover No. o LA o �` over, Mass., �"�� • d D COCHICKEWICK y^t• ADRATED p`P�t-`y S ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT.. ..............Y-4*00,0.... ' BUILDING INSPECTOR Foundation has permission to erect..... Q !��. buildings on JV!9!..,6.r ....4e ... Rough . ............................... A7 OW ��+�� Chimney to be occupied as...........I......... ......................P......... ............��......�.....j......................................................... y provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. An 940 P J?%3 _d _ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STAT Rough ........... .. ... .... ....................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE- REVERSE SIDE Smoke Det. Date.. . . � ... TM f.NOQ O o� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION y,SSACHUSE� This certifies that . . -. -. . . . . . . . . . ..y'��'r'X'-~' -' v �) has permission for gas installation . in the buildings o � �?` �. ?.? . .�� . . . . . . . . . . . . . . . . . . . at . .�`�°!. . . . . ........�' . :.,_North Andover, Mass. .Fee. .��. . . Lic. NoLe.7.:: ,✓�. . N. . . . . . . �`` *GASINSPEGT1V 6 Check# �4v l 4996 MASSACHUSETTS UNIFORM APPI-j To FOR PERMIT TO DO GAS FITTIlVG (Type or print) Date 1/8/05 NORTH ANDOVER,MASSACHUSETTS Building Locations 1401 Great Pond Rte. . nit 1 Permit# Sarah Ronsiralli �ne/ Name 978 ��� ���3 Amount New Renovation ❑ Replacemen Plans Submitted ❑ w a $36.00 a a o �a zO W a C 00 H �, C7 0 W x zW aa UCOD Gz CW7 F zd :C W C4 d Fj 1~ F rn O x o w 3 a ° a. E• o [3R UB-BASEMENT ASEMENT T. FLOOR D . FLOOR D. FLOOR 4TH . FLOOR 1STH . FLOOR 6TH . FLOOR 7TH . FLOOR # I r 8TH . FLOOR (Print or type) Eastern Propane as Q Gec one: Certificate Installing Company Name Corp. Address 131 Water S t. ❑ Partner. a n�rPr� A 012P4 'Business Telephone 1 Boo 3P? 6F pq ❑ Finn/Co. Name of Licensed Plumber or Gas Fitterd FINSURANCE COVERAGE Check t liability Insurance policy or it'ssubstantial equivalent. Yes ^ No❑ ecked yes,pleasedicate the type coverage by checking the appropriate boxance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issueqfor this application will be in Eompliance with all pertinent provisions of the Massachusetts State Code Cl er 142 a General Laws. By: Signature of i nsed PI ber Or Fitter Title Plumber 1 City/Town rq Gas Fitter Icense Num5er ❑ Master APPROVED(OFFICE USE ONLY) ❑ Journeyman N°- 2464 Date...... :. 'V f NORTN q ° <�``° '• "� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACNUSES This certifies that ................... ..........................................:............................. has permission to perform ............................::.............................................. wiring in the building of........ ......... ........ ..' at Z..,:.).1...... """`.........,:.. . }. ....,North Andover,Mass. Fee 42).�....... Lic.No f L:L� ..... . ..................... ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer ThECOAfflONWE4LTHOFAM MCUUSDIS Office Use only DEPAR7XE VTOFPUBL1CS4FETY Permit No. G BOARD OFFdREPREVEMONREGU1A770NS527OfR12.-00 � wC V Occupancy&Fees Checked ull- ,APPUCATIONFORPERAff TO PEZFO M]�,E=CAL WORK ALL WORK TO BE PERFORM M IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date C/(� Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Owner or Tenant S' Owner's Address Is this permit in conjunction with a building permit: Yes® No ® (Check Appropriate Box) Purpose of Building f►� o (�yh� I Utility Authorization No. Existing Service COG Amps.C /2ZdVolts Overhead 0a Underground Q No.of Meters New Service Amps / Volts Overhead r__J Underground No.of Meters ®� Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 64 1 No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures C� Swimming Pool Above Below Generators KVA J and 0 ground 17 No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Stoners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal ® Other Connections Np.of Water Heaters KW No.of No.of _ Signs Bailasis Not Hydro Massage Tubs No.of Motors Total HP 1 OTHER lrnr Caerage Rmat iotheregxmentsoflviasmd sctscoxrAL.aw+s Iha,xaaalagLiabtfdyhNxatcePdryulduc gCrn 6e Cae'dWcrks leWwalat YES ® NO Ihmestbrt9Tedvandprmfofsmrtotheo�YES NO Ifyufimeche& IYES,*aseirdc&thetyWot'wmaWbydrdmtgthe INSURANCE ® BOND ® OTHER ® (PeseSPa* ETit4cnDAe 7/1 work�Shart ! F_gim tedV" lwt�k$ Signcd_ p��,�y ...__._ � Final FIRM NAME C�/(RLr �✓ A �- ,J //,, 4 Lioasexv L r �,�I�oasee Sig �►�yb i� �9` LI0=T b 19 2 J r / BusimTdNa / _9,9 P 0A1tTdNa OWNER'SIISUJ CEWAIVER;Iamm=tbattheLio= $reintvrar=wmmWtrAsa le4mdatasraclzWby asdtsC ndlaws anddlimyseonthispamiiWp)iratiottwaivstttism*Mmte. (Please check one) Owner ® Agent ',,ATelephone No. PERMIT FEE Date. . .?.- No 1, 1. - 7 ♦ i ".O RT:�� TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING i i r • o ,SSACHUSE� This certifies that . . . . . . . . . . . . . . . . . . . . has permission to perform . . Rrd4 l!I. �i,c.Lil�.. . . . . . . . . . . . . . . plumbing in the buildings of . . e.. . . . . . . . . . . . . . . . . . at . r' r.��l�U.<; . . .t,_North Andover, Mass. Fee.5.4?, Lic. No.. A%-.�.`/. . . . . . {. . . . J_-�<r . . . . . . . . /E PLUMBING INSPECTOR C&x.k-fit / (! WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS /� ey ` �+ _ Date Building Location 7 CO d wners Name ` � Permit# L�rjJ Amount �^b Type of Occupancy New Renovation Replacement El Plans S miffed Yes No F1 FIXTURES En �a a W x a >4a W H W H d �a U a a d x a s Hk>~ a z Q" F d F" O p� -�q gi M F BASEM Q' M Hnm 211 FLOOR 2M HOOR 4IH HIM SIIi FLOM 6MHfM 7M FIOCR 9M FLOCR (Print or type) Check one: Certificate Installing Company Name �� � ��/t�//� M Corp. Address foild El Partner. d � Business TelephoneFirm/Co. Name of.Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box Liability insurance policy F] Other type of indemnity 1:1 Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installa4paq,performed un it Iss r this application will be in compliance with all pertinent provisions of the Massach to Pl m and C ter 142 of the General Laws. By: Signature of Licenseaer T e of Plumbing License Title City/Town License Numoer Master El Journeyman 0— APPROVED(OFFICE USE ONLY